Division of Hematology/Oncology, CHU de Québec - Centre Mère-Enfant Soleil, Quebec City, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Leuk Lymphoma. 2020 Dec;61(12):2876-2884. doi: 10.1080/10428194.2020.1789626. Epub 2020 Jul 12.
Little is known about infections occurring after childhood cancer treatment. We assessed the risk of severe infection postcancer therapy in survivors of leukemia compared to other cancer types. We performed a population-based cohort study of children <15 years of age diagnosed with cancer (2001-2016), alive and relapse-free 30 days after treatment completion. The risk of severe infection in both groups was estimated using subdistribution proportional hazard regression. We identified 6148 survivors (1960 with leukemia). The cumulative incidence (95% confidence interval) of severe infections at 3 years was 0.70% (0.40-1.2%) in leukemia and 0.51% (0.32-0.79%) in other cancers. The risk of severe infection was not statistically different in leukemia survivors compared to other cancer types in univariate and multivariate analysis (adjusted hazard ratio: 1.40, 95% CI: 0.69-2.85). No significant association was found between a history of leukemia and an increased risk of severe infection after treatment, compared to other cancer types.
关于儿童癌症治疗后发生感染的情况知之甚少。我们评估了与其他癌症类型相比，白血病患儿癌症治疗后发生严重感染的风险。我们对 2001 年至 2016 年间诊断患有癌症（<15 岁）、治疗完成后 30 天内无存活和复发的儿童进行了基于人群的队列研究。使用亚分布比例风险回归估计两组的严重感染风险。我们确定了 6148 名幸存者（1960 名患有白血病）。白血病幸存者 3 年时严重感染的累积发生率（95%置信区间）为 0.70%（0.40-1.2%），其他癌症为 0.51%（0.32-0.79%）。单因素和多因素分析均显示白血病幸存者严重感染的风险与其他癌症类型无统计学差异（调整后的危险比：1.40，95%CI：0.69-2.85）。与其他癌症类型相比，白血病患儿在治疗后发生严重感染的风险与白血病病史之间无显著相关性。
